Provider Demographics
NPI:1891293775
Name:HANNAH, KRISTEN (LMFT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:HANNAH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:AKELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3880 S BASCOM AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2675
Mailing Address - Country:US
Mailing Address - Phone:408-865-9479
Mailing Address - Fax:
Practice Address - Street 1:3880 S BASCOM AVE STE 207
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2675
Practice Address - Country:US
Practice Address - Phone:408-865-9479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT97199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health